Treatment of Chronic Rhinosinusitis with Nasal Polyps in the Nasal Cavity
Not all chronic rhinosinusitis is managed the same way. When nasal polyps are present in the nasal cavity, they define a specific phenotype that guides the treatment approach.
Clinical scenario: This protocol applies to patients with chronic rhinosinusitis with nasal polyps in the nasal cavity. The phenotypic distinction of whether or not a patient has polyps can guide treatment.
First-Line Approach
Management centres on topical intranasal corticosteroid therapy combined with nasal saline care, applied in a specific sequence that preserves medication effectiveness. The complete regimen — including agent selection, dosing schedule, duration, and sequencing — is detailed in the structured protocol.
Treatment Goals
- Reduction in nasal blockage and rhinorrhea
- Reduction in nasal polyp size
- Overall clinical improvement
References
DOI: 10.1503/cmaj.241101
- The phenotypic distinction of whether or not the patient has polyps can guide treatment.
- First-line treatments include the long-term use of topical saline and intranasal corticosteroids.
- Long-term topical intranasal corticosteroids are the first-line treatment.
- Regardless of the delivery method, irrigation should be done before using an intranasal steroid spray to avoid washing out the medication.
- Intranasal corticosteroids improved patient symptoms, reduced inflammation in the sinonasal mucosa (including the reduction of nasal polyps), and addressed related conditions such as allergic rhinitis.
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